Organization Name: | CLAIB CTY HSP PRO FEES |
NPI Number: | 1558480491 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAY L SHOEMAKER (CEO) |
Mailing Address: | 123 Mccomb Ave Port Gibson |
State: | MS US |
Postal Code: | 391502915 |
Phone Number: | 6014375141 |
Fax Number: | 6014378547 |
NPI Enumeration Date: | 03/29/2007 |
NPI Last Update Date: | 06/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |